Alternative to Methotrexate

[Poshcards]

hi, has anybody been put on an alternative to Methotrexate please, I am so fed up of being scared of this covid thingey and also dreading Flu season, since being on this drug, I get pneumonia every flu season and quite often in July too, and it is a dreadful time, I have SLE plus other artritis and asthma too xx

[Lolabridge]

Yes I had bad reactions to MTX and Sulphasalazine and Hydroxychloroquine. So I’m now on a biological drug which is working very well.

But I was under the impression that MTX does not increase your risks with Covid. It’s uncontrolled and inadequately treated RA that puts you at risk.

[oldtimer]

Firstly have a look at the treatment pages on the NRAS website and you can see the alternative treatments.

Secondly you need to discuss this with your rheumy team.

If your SLE is controlled by methotrexate, it would make sense to tackle the other problems separately. If it isn't then that's for discussion also about alternatives.

Your immune system is likely to be supressed by methotrexate back to what would be if you did not have an autoimmune condition raising it. You are therefore probably at about the same risk for other infections including respiratory tract ones - Covid-19, flu or other infections causing pneumonia (you have had the pneumonia vaccine?)

It's difficult not be anxious when there is so much anxiety raising news!

[helixhelix]

Yes, like OT my first thought was have you had the pneumococcal vaccine? Protects against pneumonia, meningitis and sepsis...

They have completely downgraded the risk levels of being on MTX. Your asthma is far more of a risk than the MTX.

MTX has a slight compromising effect on your (overactive) immune system and there are other drugs that have even less of an effect. However they may well not work as well for you as they are generally tried first when people only have mild symptoms. And uncontrolled RA increases your risk too.

Personally I’d stay on MTX, ask for a pneumocoocal and flu vaccine if you haven’t already had them, and look after the asthma as much as you can.

[Poshcards in reply to helixhelix]

Yes, had both vaccines, this years flu is a week Saturday, still get pneumonia really bad. Thanks for all of your inputs, really valued xx

[AgedCrone]

If theMtx is working for you you should thank your lucky stars. I took it for seven years and always had a flu jab.

Have you had the pneumonia jab? If not why don’t you speak to your GP about it?

[Poshcards in reply to AgedCrone]

Yes as I said above had all vaccines, flu one every year, still end up with pneumonia at least twice a year x

[Hidden]

As I understand it, we are not at increased risk from covid-19 from the low doses of MTX we take for RA. It may be a different story with the very high doses that are given for cancer treatment. My consultant told me that the important thing is to keep off steroids as much as possible as they really do make you more susceptible to the virus. So if MTX is keeping you off steroids, that is a very good thing. I agree with AgedCrone that if MTX is working for you, stick with it. If you feel it's not working for you, report that to the consultant and discuss other treatments. Very often they are given in addition to MTX rather than instead of it.